Head‐to‐head comparison of eight late gadolinium‐enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: From bench to bedside

Abstract

Purpose: To compare-theoretically and experimentallyclinically available two-dimensional/three-dimensional (2D/3D), breathhold and non-breathhold, inversionrecovery (IR) gradient-echo (GRE) sequences used to differentiate between nonviable injured and normal myocardium with late gadolinium-enhanced techniques (IR-GRE2D sequence is used as a reference), and to evaluate their respective clinical benefit. Materials and Methods:Six breathhold (2D-IR-GRE, 3D-IR-GRE, balanced steady-state free precession 2D-IRbSSFP and 3D-IR-bSSFP, phase-sensitive 2D-PSIR-GRE, and 2D-PSIR-bSSFP) and two non-breathhold late gadolinium-enhanced techniques (single-shot 2D-ssbSSFP and 2D-PSIR-ssbSSFP) were consecutively performed in 32 coronary artery disease patients with chronic myocardial infarction. Qualitative assessment and manual planimetry were performed by two independent observers. Quantitative assessment was based on percentage signal intensity elevation between injured and normal myocardium and contrast-to-noise ratio. Theoretical simulations were compared with experimental measurements performed on phantoms with various concentrations of gadolinium.Results: The 3D-IR-GRE image quality appeared better than the other 2D and 3D sequences, showing better delineation of complex nontransmural lesions, with significantly higher percentage signal intensity and contrast-tonoise ratio. PSIR techniques appeared more limited in differentiating sub-endocardial lesions and intracavity blood pool, but in all other cases were comparable to the other techniques. Single-shot PSIR-ssbSSFP appeared to be a valuable alternative technique when breathhold cannot be achieved. Conclusion:We recommend 3D-IR-GRE as the method of choice for late gadolinium-enhanced cardiac magnetic resonance imaging in clinical practice.

Three-Dimensional Phase-Sensitive Inversion-Recovery Turbo FLASH Sequence for the Assessment of Left Ventricular Myocardial Scar in Swine

“…In a previous study that used a 3D inversion-recovery fast low-angle shot sequence, only moderate agreement for scar transmurality was observed probably owing to the rather long acquisition time of 293 msec per heartbeat [8]. In contrast, in this study, the imaging time per heartbeat for the 3D PSIR Turbo FLASH sequence was 129 msec.…”

“…The 2D PSIR Turbo FLASH was used as a standard reference in this study because it was previously demonstrated [8,22]and widely used to assess myocardial viability in routine clinical practice [24-28]. However, this technique requires good patient cooperation.…”

Three-dimensional phase-sensitive inversion recovery sequencing in the evaluation of left ventricular myocardial scars in ischemic and non-ischemic cardiomyopathy: Comparison to three-dimensional inversion recovery sequencing

“…One important disadvantage of LGE-MRI with the 3D PSIR sequence is the extended acquisition time [15,21,27,37]. Nonetheless, use of the PSIR technique reduced the effects of dynamic changes in TI and maintained excellent contrast between normal and fibrous myocardium despite its longer acquisition time, whereas the IR images lost contrast over time.…”

“…The most widely used pulse sequence type of LGE-MRI is inversion recovery (IR) [15] with magnitude reconstruction, which http://dx.doi.org/10.1016/j.ejrad.2014.09.014 0720-048X/© 2014 Elsevier Ireland Ltd. All rights reserved. is typically performed for 5-15 min after the administration of gadolinium contrast material.…”

Myocardial Viability on Cardiac Magnetic Resonance

“…43-45 The best technique is chosen and adapted depending on the clinical condition of the patient, the manufacturer of the available equipment, and the experience of the local group.…”